Find work in the United States.

A simpler way to find your next job.

Jobs in the United States

25+ jobs

Save this search

Added just now
Director, Occupational Health, New Jersey
E.R. Squibb & Sons,L.L.C.
Summit West, NJ · Princeton, NJ · New Brunswick, NJ
Ensure compliance with local, state, and federal health and safety regulations.
Added 1 min ago
S
Surgical Technologist - L&D Full-time Night Shift
SBHU
Stony Brook, NY
- Full-time
Tests operational efficiency of equipment and reports problems to the L&D Clinician or nurse manager.
Added 1 min ago
Territory Account Manager - Cincinnati
GSK
Cincinnati, KY
ViiV Healthcare is a global specialty HIV company, the only one that is 100% focused on researching and delivering new medicines for people living with, and at risk of, HIV. ViiV Healthcare…
Added 1 min ago
G
Territory Account Manager HIV Prevention, Burbank, CA
GSK
Burbank, CA
- $132,750 to $221,250 USD / year
ViiV Healthcare is a global specialty HIV company, the only one that is 100% focused on researching and delivering new medicines for people living with, and at risk of, HIV. ViiV Healthcare…
Added 1 min ago
SJ
Financial Services Associate
San Joaquin Valley College
San Leandro, CA
- $20 to $28 USD / hour
The Financial Services Associate meets with applicants and students regarding their eligibility for federal financial aid programs by calculating anticipated awards in PELL, SEOG,…
Added 1 min ago
Home Health Business Development Liaison - Account Manager
Choice Rehab LLC
Tucson, AZ
Demonstrate an in-depth knowledge of, and ensure compliance with, all local, state and federal laws relating to marketing of the agency.
Added 2 mins ago
Team Lead, Pharmacy Overnight - Mesa
DSV
Mesa, AZ
The Inventory Lead is responsible for operating MHEs for the purpose of moving, locating, relocating, stacking, and counting. Computer data entry is required for receipts, shipments, and…
Added 2 mins ago
District Manager
Circle K
HOUSTON, TX
…activity; reporting business opportunities, results, trends and competitive information. Manages controllable costs by educating managers on procedures for controlling merchandise…
Added 2 mins ago
S
Surgical Technologist - L&D Full-time Night Shift
SBHU
Stony Brook, NY
- Full-time
Tests operational efficiency of equipment and reports problems to the L&D Clinician or nurse manager.
Added 3 mins ago
State Health Coordinator
TX-HHSC-DSHS-DFPS
AUSTIN, TX
Under the supervision of the Children and Youth with Special Health Care Needs (CYSHCN) Systems Development Group Manager, the CYSHCN Health Coordinator performs highly advanced…
Added 3 mins ago
SB
Risk Specialist
Southwest Behavioral & Health Services
PHOENIX, AZ
- $18.5 USD / hour
Responsible for a variety of support functions within the Risk Management Department. Responsible for various audits and reports as assigned by the Insurance Program Manager, Director,…
Added 3 mins ago
Farm Aide
Texas A&M University - Kingsville
Kingsville, TX
This position requires compliance with state and federal laws/codes and Texas A&M University System/TAMUK policies, regulations, rules, and procedures
Added 4 mins ago
RU
Manager, Manufacturing & Process Execution DAP
Resilience US, LLC
West Chester, OH
- $100,000 to $148,750 USD / year
The Manager, Manufacturing – DAP owns the performance of the DAP Line Operation - its people, resources, schedule, and results - setting operational priorities and allocating staffing and…
Added 4 mins ago
Assistant Moving Center Manager
U-Haul Co. of Georgia
Forest Park, GA
…consider becoming U-Haul Company’s newest assistant general manager! As assistant general manager, you will frequently be responsible for the day-to-day operations of your center, working…
Added 4 mins ago
Assistant Moving Center Manager
U-Haul Co. of Georgia
Decatur, GA
…consider becoming U-Haul Company’s newest assistant general manager! As assistant general manager, you will frequently be responsible for the day-to-day operations of your center, working…
Added 4 mins ago
Assistant Moving Center Manager
U-Haul Co. of Texas
San Antonio, TX
…consider becoming U-Haul Company’s newest assistant general manager! As assistant general manager, you will frequently be responsible for the day-to-day operations of your center, working…
Added 5 mins ago
Enrollment Manager
Flowers Early Learning
Paw Paw, MI
Position Summary: This position oversees all aspects of the application, eligibility, and enrollment system, including collecting applicants and other data, determining eligibility,…
Added 5 mins ago
Family Case Manager
State of Indiana
North Vernon, IN
Thorough knowledge of state and/or federal laws, regulations, guidelines, and standards affecting child protection services, foster care, family preservation and adoption.
Added 5 mins ago
Family Case Manager
State of Indiana
Sullivan, IN
Thorough knowledge of state and/or federal laws, regulations, guidelines, and standards affecting child protection services, foster care, family preservation and adoption.
Added 5 mins ago
Industrial Services Operations Manager
Crystal Clean
McClellan, CA
Knowledge of federal, state, and local hazardous waste and safety regulations.
Added 6 mins ago
Channel Manager
Delta Faucet Company
IN · NC
The Channel Manager supports the execution of customer and category initiatives for bathing, shower doors, kitchen sinks, pro initiatives and emerging categories like water quality and…
Added 6 mins ago
Balance Sheet Specialist
PNC
Pittsburgh, PA
PNC offers a comprehensive range of benefits to help meet your needs now and in the future. Depending on your eligibility, options for full-time employees include: medical/prescription drug…
Added 6 mins ago
Compliance Program Advisor
PNC
Charlotte, NC · Cleveland, OH · Pittsburgh, PA
At PNC, our people are our greatest differentiator and competitive advantage in the markets we serve. We are all united in delivering the best experience for our customers. We work together…
Added 6 mins ago
Branch Manager
PNC
West Palm Beach, FL
At PNC, our people are our greatest differentiator and competitive advantage in the markets we serve. We are all united in delivering the best experience for our customers. We work together…
Added 6 mins ago
RN-Manager Invasive Cardiac Services
Eisenhower Medical Center
United States
Responsible and accountable for the clinical and personnel functions of assigned units. Responsible for assisting in development, implementation and integration of performance improvement…

Excellus BlueCross BlueShield

Medicare Segment Manager

Rochester, NY, United States

Apply About employer

Applications open in a new tab.

Job details

Posting language: English
Posted: Nov 1, 2026

Original job description

Job Description:

Summary:

Under the general direction of the Assigned Management, this position is responsible for supporting Medicare line of business strategy and execution. assuring that all Medicare products and programs are administered according to approved benefit design, regulatory requirements, and strategic objectives for the line of business. The incumbent is accountable for service and operational requirements associated with the line of business. The incumbent will be knowledgeable in all Medicare products, including Medicare Advantage, Medicare Supplement, Part D Prescription Drug Plans, and Dual Eligible products.

Essential Responsibilities/ Accountabilities:

· Develops strategic, operational, and tactical business plans to achieve desired business goals for the Medicare lines of business.

· Understands and evaluates new market opportunities, including building of necessary business cases.

· Conducts evaluation, review, and assessment of various operations for the purpose of identifying root causes of operations problems that contribute to noncompliance and customer

dissatisfaction.

· Consults with team members and stakeholders to streamline system operations and processes to improve business effectiveness and efficiency.

· Plans, develops, and implements special projects, initiatives, and activities to support line of business objectives, product, benefit administration, regulatory requirements, process

improvement, efficiency, and the customer experience.

· Encourages innovation, process improvements and personal development within the functional business areas that support the Medicare products.

· Develops and maintains relationships across the enterprise to promote consistent strategic priorities.

· May serve as a regulatory liaison to NYS, CMS or BCBSA as needed.

· Collaborates with cross functional business and project teams to ensure alignment to line of business objectives, compliance, operational performance and process improvement.

· Ensures cross functional integration of strategies with key internal areas including, but not limited to Marketing, Operational Excellence, Population Health Engagement, Finance, Provider

Contracting, Compliance and Enterprise information Technology. Represents Medicare on related key cross-functional committees and projects to ensure Medicare perspective is being

integrated into strategies of other areas.

· Manages maintenance of business process work item deliverables. Regularly participates in forums and activities to solicit direct customer feedback.

· Reads, interprets, and identifies necessary next steps related to complex government regulations.

· Engages in issue identification as well as problem solving to identify and resolve potential improvement opportunities.

· Serves as a corporate resource for Medicare, providing line of business subject matter expertise to business teams on initiatives and activities that impact the line of business.

· Acts quickly to continuous changes and challenges in the regulatory environment.

· Works closely with other Departments for input and integration. Ensures all perspectives are considered and develops processes and timelines to incorporate planning and execution of

strategies across departments.

· Remains current on evolving market dynamics within the Medicare segment, connects trends to line of business objectives and ensures awareness among key business partners.

· Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct, and leading to the

Lifetime Way values and beliefs.

· Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.

· Regular and reliable attendance is expected and required.

· Performs other functions as assigned by management.

Minimum Qualifications:

· Bachelor’s degree in health administration, marketing, business administration or related field with a minimum of six years progressive health plan operations experience.

· Strong leadership and/or management experience.

· Strong expertise and background dealing with regulatory and accreditation agencies such as NCQA, CMS, Federal & State agencies including DOH, Dept. of Finance Services.

· Remain current on all relevant regulatory requirements.

· Strong process and program management skills, analytical, creativity and initiative in problem solving and solution identification.

· Strong facilitation skills and follow through. Project management experience required.

· Must be a critical thinker and possess effective negotiation skills in dealing with middle and senior management levels.

· Must be self-motivated and a self-starter, able to work independently at times without detailed direction.

· Must possess strong computer skills, including MS Word, Excel and PowerPoint.

· Must possess strong, demonstrated analytical ability, strategic thinking, and creativity as well as a positive attitude, strong work ethic and highly effective communication skills.

· Must be capable of establishing effective relationships with all levels of representation throughout the divisions including senior management to execute cross-divisional initiatives.

Physical Requirements:

· Ability to travel across the health plan service regions as needed.

In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.

Equal Opportunity Employer

Compensation Range(s):

Minimum: $79,068 - Maximum: $142,322

The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position’s minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays.

Please note: There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Apply About employer

More about this job

Skills

CMS
Regulatory compliance
Process improvement
Business processes
Problem solving
Leadership
Program management
Project management
Negotiation
Work independently
Computer skills
Microsoft Word
Microsoft Excel
Microsoft PowerPoint
Communication skills
Compensation and benefits
Recruitment

Report this job